Why do PTSD-sufferers sometimes refuse to admit they have PTSD? Some trauma survivors will deny they have PTSD. Their PTSD-coping behaviors damage themselves and their most important relationships, but they refuse the possibility of PTSD even though they have survived trauma. At times, someone who earlier recognized they may have PTSD may later deny it. What gives here? What follows is not so much an essay as quick thoughts written during my latest round of insomnia.
For Military-based PTSD:
- PTSD stigma is a liability, a risk, career damaging.
- We don’t want to admit to the vulnerability or the perceived weakness of a non-physical wound.
- We don’t want to hear accusations of faking it, or just looking for pity and money.
- We don’t want to be criticized or scoffed at by toxic people who will minimize or outright deny our trauma and subsequent PTSD.
Troops fear the stigma of PTSD on their career. If they report the effects of stress they may, depending on their unit commander, lose their security clearance or job specialty. They are in-effect being told they are no longer the complete soldier they were before the trauma…this damages our identity.
Some Effects of Denial:
If a person remains in denial they will avoid treatment in those cases where treatment might be available. This will result in quite a few situations that could have been avoided with treatment:
- Worsening of the problem in and of itself.
- Alienation and loss of important relationships.
- Deterioration of job performance, then disciplined for the decline.
- Embrace of more negative, dangerous coping behaviors.
Anecdotally, denial and refusal to admit that one may have PTSD is highest among those suffering from military trauma. The civilian public, and even some members of the military, will reject the possibility of someone’s military PTSD because the causes do not align with what the popular mindset defines as traditional combat experience.
Denial of Domestic Sexual or Gun Abuse
Amongst (and again, anecdotally) those who suffered sexual abuse, many deny they have PTSD. This results from the elements of guilt, humiliation, downgrading of the circumstances, and public doubt of the actual occurrence of the trauma.
Survivors may experience a range of denial responses from the public. They may deal with indifference as to how the public responds to sexual crimes. They may actually be blamed for being the victims of the trauma themselves, because their clothes were too revealing, or they we not escorted by a man. The public often inflicts similar attitudes against victims of incest, sibling abuse, and abuse perpetrated by clergy, coaches, or teachers.
Like gun violence, sexual violence will generate some loud chest thumping and rhetoric, but little will get done about it. The survivors of these forms of violence will quickly recognize the empty crocodile tears shed over their suffering.
Denial Because We Are Tired of Others’ Denials
As foreshadowed above, sometimes we may deny we have PTSD because we cannot deal with yet another know-nothing individual saying that PTSD does not exist, or that we are just faking it, or they think we are trying to register a false claim in the hope we may see some money.
And, there are those who feel they somehow have the right to ask us all sorts of personal questions about our trauma. They add salt to this invasive wound by discounting our trauma and PTSD. Why? Because they know someone who went through something ten times worse and that person is just fine…so how could you or I have a problem with PTSD?
If they actually do know someone who has been through something ten times worse and their attitudes with them are as intrusive and as judgmental as the ones they use on you or I, then no wonder their “friend” would refuse to confide in them.
Avoiding Treatment by Avoiding Diagnosis
We may deny PTSD because then it might mean that we would feel obligated to try and heal from its ravages. Some folks do not want to go to the doctor for fear of what the doctor might tell them. If they can avoid a diagnosis then they feel they don’t have to act on these symptoms.
Regardless of the Source of the Trauma
To realize that we have a breaking point, a point where traumatic stress overwhelmed us, is a hard truth to grapple with. It can often provoke deep shame or a sense of weakness within us.
For those of us with a military background, we often imbibed the notion that nothing was bigger than we are. Now we find we are broken. Not because we choose to be broken (who ever really does?), but because like a broken bone we have no choice about, the traumatic stress has broken something within us.
The same applies to those who survive sexual assault and or survive the tragic loss of someone they love and care about.
When we find we carry PTSD’s soul wound, we may feel as if we have betrayed ourselves, ashamed, or weak. Many of us grew up on John Wayne movies and “the Duke” didn’t get PTSD on the big screen. More’s the pity, as it may have given many of us permission to be fully human and not to try and suppress the portion of ourselves that felt most deeply.
We May Change Our Minds
We may have been initially been diagnosed with PTSD. When we see how society and the military command structures treat those with PTSD or who are tempted by suicide, we may change our minds and deny we had been affected by trauma.
If we see how careers may stop or how someone is called “weak” we may decide that it is too risky to admit to being affected by traumatic stress.
We Remain Accountable
If we engage in negative behaviors that attempt to soften the PTSD pain, we remain accountable for those behaviors.
Striving for “Normal”
Often in the first months after a trauma (and for the military this would be a redeployment back to the States) we may try to force a sense of normalcy back into our lives at a faster rate than it would come naturally. Fast engagements and quick marriages may result. In general we are taught that marriage, parenthood, and owning a big mortgage are hallmarks of stability and normalcy. We may try to prove to ourselves that we are ”normal” and not affected by PTSD by rushing into various relationships too fast.
We may jettison our earlier relationships because the PTSD tells us that we have nothing in common anymore. The person who left is not the person who came back. The relationships that were firm when we left, may (but, not always) feel adequate when we return. We may seek out people who are just as damaged as we are in the mistaken feeling that this will justify our PTSD behaviors.
The more harshly old relationships are damaged, and the more quickly that new pre-damaged relationships are entered into, then the harder it is to find out who we really are, to find out what my real identity is.
When trapped by the PTSD-Identity: I would feel as if my identity was shaped by trauma, helplessness, betrayal, regret, every step cursed…such is a portion of the PTSD journey.
Why do we deny we may be afflicted with PTSD?
A. We just honestly don’t know that we have it (and commanders and NCOs fail us when they don’t notice it for us). We feel trapped by these seemingly inexplicable changes going on inside of us. Usually, we can’t even describe it in words.
B. I may know something is wrong. It may even match up with this PTSD stuff I hear about. But I know that America does not really care. Because, like repeated episodes of gun violence, the grown-ups wring their hands and cry, and then do nothing that helps. Sometimes the trauma has taught us not to trust. Other times when we see how the grown-ups react to serious situations, what they are willing to let happen without significant change, then we learn that they cannot be trusted with our wounds either. Since PTSD is a soul wound, we are especially careful who we will trust with our souls.
Why Might we Reject Love and Healthy relationships?
A. We may reject those we have loved because our ability to trust and love have been damaged…after all, we are talking about a wound to our soul. PTSD may have convinced us that we never were really in love before. In this way it retrojects the shame, fear, anger, and mistrust backwards into our former relationships.
B. We may feel that we are no longer lovable. Best to cut people off and attempt a clean break. Usually we don’t know the mechanics of this when we are busy doing it.
C. We may just be jerks or dickweeds plain and simple, with or without PTSD.
Your mileage may vary.
Alas, I have not done this topic justice.
Parts of this are over-written and other parts are underwritten. But sometimes a sleep-deprived shoddy draft may be better than remaining silent on a live topic.
With any luck we will all sleep a bit better tonight…maybe I had some more of my own bitterness to get out by writing, who knows for sure?
There is no truth in PTSD denial. Ultimately, we should strive for truth, the common good. Regardless of the challenges our society poses, we still need to find the courage and love to seek help. If in doubt about PTSD, seek help.
Not every set of symptoms adds up to PTSD, but you won’t know if you don’t find out. If you deny, then you encourage the PTSD to ruin your life and the lives of others. You and those who care about you are more important. You have value.
But, if you suffer from PTSD or not, you always have value, you are always constantly being created by love in the image and likeness of God.
Semper Pax, Dr. Z